Upton Baptist Church Holiday Bible Club Registration 2019 - PENTATHLON
Email address *
Child's Name *
Your answer
Date of Birth *
Your answer
School Year (year child is going into in September) *
Your answer
Parent/Carer's Name & Address *
Your answer
Contact phone number *
Your answer
Emergency contact names and phone numbers (please supply two names) *
Your answer
Please indicate any allergies, medical conditions/medication or anything else we should know *
Your answer
I give permission for photographs/videos to be taken within the club and shown at future events in the church. *
I give permission for photographs/videos to be taken within the club and shown on the church's website and Facebook page. *
I give permission for my child's details to be retained for use for Holiday Bible Club purposes (these will not be passed or made available to third parties) *
I give permission for my child to have juice and snacks *
In the unlikely event of illness or accident, I give permission for appropriate first aid to be given. In an emergency, and if I cannot be contacted, I am willing for my child to be given hospital treatment, including anaesthetic if necessary. I understand that every effort will be made to contact me as soon as possible. *
I confirm that the above details are complete and correct to the best of my knowledge. *
Required
Name/Signature *
Your answer
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